Understand that the skill of giving feedback is central to effective teaching and supervision. Communicate goals and objectives of feedback clearly from the outset. Begin feedback sessions with the learner's self-assessment. Provide feedback in a timely manner. Reinforce and correct observed behaviours. Confirm the learner's understanding and conclude with an action plan. Develop a capacity in trainees to self-reflect on their own practice and how it might be improved. Learning objectivesTo understand the principles of how to give effective feedback. To be familiar with the models of giving feedback. To understand why medical educators sometimes fail at giving feedback. Ethical issuesBeing dishonestly kind in giving feedback. Unconscious bias in providing feedback.

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Objective To determine whether administration of exogenous human chorionic gonadotrophin (hCG) treatment improve the pregnancy outcome in first trimester threatened miscarriages. Design A prospective, double blind, randomised, placebo-controlled trial.Setting The Early Pregnancy Assessment Unit, Royal Bolton Hospital, Bolton, United Kingdom.Population One hundred and eighty-three women with vaginal bleeding and a viable fetus seen on ultrasound scan (USS) in the first 12 weeks of pregnancy. Methods The patients were randomised to receive either hCG or placebo treatment until 14 weeks of gestation.Main outcome measures The primary objective of the trial was to determine the miscarriage rate in the hCG arm compared from the placebo arm. Results Of the 183 cases, 87 were randomised to treatment with hCG while 96 were randomised to receive a placebo. Forty-seven (25%) did not comply with the study protocol. 5] in the study. The number of patients actively bleeding per vaginum at presentation was 85 (93%) in placebo group and 79 (96%) in the hCG group. The median number of hCG or placebo injections for both groups was 7. Ten women (11%) in the placebo group proceeded to have a complete miscarriage, as did 10 women (12%) in the hCG group, relative risk (RR) [95% confidence interval (CI)] of 1.1 (0.63 -1.6). Conclusion Our study showed no evidence of a difference in the outcome of threatened miscarriages when treated with hCG in the first trimester, this may be because our study sample size was small and follow up was suboptimal. A large, randomised, multicentre trial is still needed to establish the usefulness of hCG treatment in cases of threatened miscarriage.

Key content:• A recent RCOG guideline stated that, in a woman who is haemodynamically stable, a laparoscopic approach to the surgical management of tubal ectopic pregnancy is preferable to an open approach.• Two national surveys showed that the technique was employed routinely in only 27% and 35% of cases.• In surveys, trainees in obstetrics and gynaecology frequently commented that they needed more supervision by consultants when carrying out this procedure. Learning objectives:• To learn about why improvements need to be made in training for this procedure.• To learn about the opportunities available for training.

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